How to come off mirtazapine safely
Posted , 56 users are following.
Been on Mirtazapine for approx 4 months, currently 22.5mg. Also taking 40mg Seroxat. What's the best way to come off Mirtazapine? The side effects outweigh the benefits. The medical profession have just left me in limbo. They were quick to put me on to the Mirtazapine but have offered no help in coming off. The waiting list to see a physchiatrist is months. The duty doctor just told me to go from 30mg to 15mg & then come straight off them. My own doctor said that there's not much she can do other than help me with the insomnia by prescribing me a week's supply of 7.5mg Zopiclone but no more after because they're addictive. So i feel that i am well & truly in complete limbo at the moment. Due to the insomnia, they advised me to go back on 30mg but the side effects were too harsh. They then advised me to drop to 22.5mg but still the insomnia continues & side effects are harsh. I've been sleeping 4 hours per night roughly for the last 2 weeks, which is having a detrimental impact on my mental & physical health. I feel the sooner i can safely get off the awful drug the better. The longer i take it the worse the withdrawals will be. I do realise that some withdrawals are inevitable but i obviously would like to limit the severity & duration. Any help would be appreciated.
2 likes, 101 replies
danw32 tim11033
Edited
Hiya Tim, I'm going through the same process and before I moved house (have an amazing gp now) I must have seen 10 different doctors, all with different opinions. I totally agree with Christine, withdrawal isn't taken seriously and most GPs just aren't trained to deal with it. They just believe what they are told from the drug reps. Telling you to take half a tablet for 2 weeks and then nothing, is like telling a heroin addict just take it every other day and then stop. It ain't gunna happen. I did that a year ago when I was on citalopram and was shaking in bed. I thought I had a cold but was withdrawal.
I've been on 7.5mg for 2 months now, down from 30, which has literally taken me 18months. I cut 15mg tablets into 8ths and have that every month. Even then I suffer but you can't cut any more. Another option is the get the dispersable tablets and measure it out that way (there's a good thread on here about that). But I'd suggest, if you do a drop, don't be tempted to go back up when you are struggling. Any drop is a step forward. I'm off work on long term sick but 50% of this is due to symptoms from the drug that's meant to be helping me. That's how bad it is, insomnia, dizziness, stomach problems and really achey back and shoulder blades. I was on zopiclone too and then it stopped working. At no point did the doctors say it was the drugs causing it or that it would be so bad.
I'd suggest stay on what you are for about 6 weeks, then reduce by an 8th or a quarter every month. Use a sharp knife or pill cutter.
Please let us know how you get on.
Dan
christine15542 danw32
Edited
Hi Dan
You made a good point there regarding keeping the drop in dosage no matter how hard the struggle is. I think it is important to tell yourself that this is WITHDRAWAL and it will get better. I also think the doctors underestimate how crippling insomnia is. I would not have believed how long and protracted the withdrawal symptoms are from this drug. I even researched heroin withdrawal cold turkey at home and it was less protracted than mirtazapine. I'm not using scare tactics. I just think it's important that anyone wanting to come off mirtazapine take it very slowly and accept that the slower you taper, the less the symptoms of withdrawal will be. Also to accept that there will be withdrawals no matter how slowly the taper. I had no understanding from my gp. One medical professional actually said to me, when I was absolutely incapacitated by lack of sleep, that I had ONLY been on it for 6 months. After taking mirtazapine for 2 -3 weeks it's got its hooks well and truly into your system.
My heart goes out to each an everyone battling this drug because the truly appalling aspect is the refusal from the medical professionals to accept that there are serious withdrawal symptoms and the subsequent lack of support when in withdrawal
tim11033 danw32
Posted
Hi Dan,
I have just had a call from the local crisis team. They told me the plan is to take 22.5mg for 2 weeks, 15mg for 2 weeks & then 7.5mg for 2 weeks & then 0.
They also said that they would not offer any sleeping tablets or diazipam at present.
danw32 tim11033
Edited
Hey Tim, that's way too quick. Seriously. Believe me I've tried it! I think depending on your genetic make up, some people suffer less. But I'd say at the very least cut your 15mg tablets into quarters. They snap in half then use a sharp knife (I use a Swiss army knife!) to cut length ways down the half a tablet. And do a drop every month. I found out I'm even sensitive to different batches, so it's something to bear in mind. I got my doctor to prescribe me 6 months of tabs and spoke to pharmacist about getting all same batch. I'm using actavis brand, which are easier to cut. Teva are circular and harder to cut.
I hope that helps. Lack of sleep is a total killer, I've decided to come off my 7.5mg and I'll be the same! As long as we all get the support we need it should be easier :-) Hope that helps and please keep us updated.
Dan
danw32 christine15542
Posted
Couldn't have put it better myself. Apparently NICE published a report a few months ago on antidepressant withdrawal and how serious it should be taken. I'm sure it was new news t some medical professionals. Which doesn't fill you with confidence. I'm sort of lucky as I'm a biochemist by trade but poor folk taking doctors words as gospel are suffering needlessly. Also an interesting Guardian article about exactly what we're discussing. I'll post on here if you've not read it.
Cheers
christine15542 danw32
Posted
Yes please. If you could post that article, I would love to read it.
Cheers.
tim11033 danw32
Posted
The only problem i have is they're prescribing the medication so don't have many extra tablets. I only have 2 weeks supply of 22.5mg, lots of 30mg that i can split them. So i could do 22.5mg for 2 weeks, 15mg for how long? & then they give me 2 weeks supply of 7.5mg. So if i wanted to go lower i would have to split a 30mg tablet into smaller pieces? What would be your plan? Really appreciate your advice
howellsxo tim11033
Posted
i was on mirtazapine for 2 years. started at 15mg and worked up to 45mg in a bery short space of time,
i have severe emetaphobia and anorexia so i guess they thought putting me on this drug would help me gain weight. it did not iv lost 3 stone in the 3 years iv been on it and had worse anxiety surrounding my emetaphobia to the point where in the past 3 months iv not even left the house. 3 times the doctor has tried to get me to do the drops youve mentioned.
go to 30mg for a week then 15 then nothing.
i strongly advise against this. it was hell and o had to go back to 45. since then iv been dropping down by 3.75 every two weeks. im now down to 33.75mg (its taken almost 2 months to get here) its been horrible but im able to ride each drop out better than i was able to to do the drop straight down to 30 and 15!
christine15542 tim11033
Edited
Hi Tim
Another thing worth trying is melatonin. There are brands available - they are not cheap but some of them can ease anxiety at night coupled with magnesium and it might be worth taking a melatonin capsule if you wake during the night. If you can drift off to sleep but wake later on try a camomile tea with a melatonin cap. Believe me, I've tried everything and when you are alone in the darkest hour before dawn, anything is worth a try. I did also try the drugs that help with allergies as they are antihistamines and they make you drowsy. They help some people sleep.
tim11033 christine15542
Posted
Thanks Christine. They won't give me any more sleeping pills (they only gave me 7) & no diazipam either. They told me to take 22.5mg Mirtazapine for 2 weeks, 15mg for 2 weeks, 7.5mg for 2 weeks & then 0.
danw32 tim11033
Posted
I'd ask for some 15mg tablets. If you ask they should definitely give you them. And if the doctor gets funny just state your case. If they still don't, see someone else. I had to do that when they wouldn't give me any. 2 weeks on such a big drop would be too big for you. Also agree, melatonin is a great idea. It can work for some people.
I've posted that guardian article but apparently it's waiting to be moderated......
Cheers
tim11033 danw32
Posted
Hi Dan,
So what would be your plan for me?
I have 2 weeks supply of 22.5mg, lots of 30mg to split to 15mg & then he'll give me 15mg to split into 7.5mg
danw32 tim11033
Posted
That's good you've got some 30s. The problem would be if you ran short and had to wait weeks for an appointment. If you're on 22.5 now, I'd stay on that for a total of at least 4 weeks. Then if you can, chop up what you've got to get to 18.75mg and do that for a month. Then on 15mg for a month, all the way down to zero in 3.75mg increments. I'm doing increments of half 3.75. 15mg tablets are easy to work with at 30mg are a faff to cut. Does that make sense?
tim11033 danw32
Edited
Hi Dan, sorry for late reply but my phone went dead. I've only got 2 weeks supply of 22.5mg. Plenty of 30s that i can half to 15 & then they will give me 2 weeks supply of 15mg to half to 7.5mg. So what would be the best way?
danw32 tim11033
Edited
Yeah, just use a knife to chop them up and go down 3.75 increments. I'd go back to your docs and ask for 15s. Easier to cut.
tim11033 danw32
Posted
Ok will do. But i've only got 2 weeks supply of 22.5mg & approx 2-3 weeks supply of 30mg to half to 15mg. After that i will have to get some 15mg & half them to 7.5mg for a couple of weeks & if they give me some more 15mg i can split to 3.75mg for a couple of weeks.
I know that's probably not ideal. But they are adamant about what the plan is. In fact my gp says she can't get involved regarding this medication & that it's down to the local mental health services to deal with.
danw32 tim11033
Posted
Man that sucks. Their plan is to sh1t! Get booked in to see a different doctor if you can. That's ridiculous saying she can't get involved. She washing her hands mate, get booked in to see someone else. Good luck! Let me know if you have any joy.
tim11033 danw32
Posted
It's been put on the system that the local mental health team are dealing with it. So there's really no way around that. They given me 2 weeks supply of 22.5mg, i have about 2-3 weeks supply of 30mg that i can half to 15mg then they're giving me 2 weeks supply of 15mg to half to 7.5mg. But i will ask them for more 15mg so i can split them down to 3.75mg for a couple of weeks instead of completely coming off from 7.5mg.
danw32 tim11033
Posted
Definitely maye, you need to have a word and tell them you're not happy. Bit of a joke really. Get them to give you more. You'll probably have to state your case and be assertive.
tim11033 danw32
Posted
22.5mg for 2 weeks
15mg for 2-3 weeks
7.5mg for 2 weeks
3.75mg for 2 weeks
danw32 tim11033
Posted
That sounds like a good plan mate. The jumps are quite big but hopefully you'll tolerate it. If not, keep badgering them!!
tim11033 danw32
Posted
I have been on Paroxetine for 22 years which worked well just the occasional blip. However they decided to put me on Mirtazapine & wean me off Paroxetine. However i got to 20mg Paroxetine & just came off. 3 weeks later i informed the doctor who rushed me straight back on the Paroxetine. So now i'm back on the Paroxetine i don't want to stay on the Mirtazapine. Hence why i'm coming off them.
danw32 tim11033
Posted
tim11033 danw32
Posted
I know that's why i've decided to stay on the Paroxetine. I had a terrible 3 weeks when i came off it. The Mirtazapine may of helped during that time, but since i been back on my usual dose of 40mg Paroxetine i don't see the point of staying on the Mirtazapine aswel.